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A 37-year-old woman with chronic hepatitis C presented with blurred vision after losing her eyeglasses. Her corrected visual acuity was 20/30 in both eyes. On questioning, she reported intravenous use — when she was 14 to 20 years old — of methylphenidate hydrochloride (Ritalin) tablets crushed and dissolved in water. Physical examination revealed glistening crystals scattered throughout both maculae (Panels A and B, arrows). A recent liver biopsy for the evaluation of the patient's hepatitis C infection showed abundant talc particles under polarized light (Panel C). The hepatic central vein was surrounded by macrophages containing phagocytized talc particles, which were . . . [Full Text of this Article] |
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